In 2003, PEPFAR added an “anti-prostitution loyalty oath” to their funding. The pledge requires organisations to take an anti-sex work stance. It eliminates funding for organisations that support a harm reduction model in working with sex workers. The oath is part of an anti-trafficking push by the US government, which conflates sex work with human trafficking. More information on this inaccurate view on sex work can be found in the five-page NSWP briefing paper Sex Work is Not Trafficking.

In 2013, the “anti-prostitution loyalty oath” was challenged by Open Society Foundation on the grounds of free speech. The challenge was successful in removing the oath for projects in the United States, however the oath remains for international organisations.

They also provided a number of ways to continue advocacy against the “anti-prostitution loyalty oath,” including engaging with local PEPFAR teams through US embassies in each country. PEPFAR will also be starting quarterly civil society consultations with key populations. Sex workers and allies are encouraged by SWOP USA to provide feedback at these consultations against the oath. The campaign and online consultation ended November 19. PEPFAR will post the final guidance on December 1, World AIDS Day.